Advances in the mechanism for steroid-induced osteonecrosis of the femoral head

Abstract Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating condition resulting from the use of glucocorticoids, commonly prescribed for immune-related and inflammatory diseases. Understanding the mechanisms driving SONFH remains a significant challenge, complicating efforts to prevent and treat the condition. While genetic predispositions, impaired blood supply, and metabolic changes are recognized contributors, the complex interplay between these factors is not yet fully understood. Recent research has shed light on the pathogenesis of SONFH, exploring it from multiple perspectives, including tissue-level damage, cellular dysfunction, and molecular pathways. This review summarizes these recent advancements, providing an integrated understanding of the onset and progression of the condition. Additionally, it highlights emerging therapeutic strategies that potentially pave the way for more effective treatments in the future.